Provider Demographics
NPI:1780719195
Name:BARRY, PATRICIA ANN (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:BARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1529
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-7529
Mailing Address - Country:US
Mailing Address - Phone:516-629-2400
Mailing Address - Fax:516-629-2113
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:WOMEN'S CENTER
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1353
Practice Address - Country:US
Practice Address - Phone:516-629-2400
Practice Address - Fax:516-629-2113
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1607982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY160798OtherLICENSE
NY160798OtherLICENSE
NY160798OtherLICENSE
F08008Medicare UPIN